PCS Assessor, RN

Job Description:

• Schedule assessments with members, family members, and healthcare professionals
• Conduct standardized assessments to determine PCS eligibility
• Conduct interviews with family members and informal caregivers
• Complete assessments within established timeframes
• Perform expedited assessments by phone as needed
• Educate and assist members in selecting PCS providers
• Collaborate with prescribers and healthcare professionals to ensure requests are accurate and complete
• Submit service authorization requests (SARs) for PCS providers
• Maintain the privacy and dignity of individuals receiving PCS assessments
• Participate in mediation and appeal processes
• Respond to state inquiries regarding completed assessments
• Attend and actively participate in staff meetings
• Conduct case consultations, peer reviews, and internal audits as assigned
• Develop level-of-care recommendations based on clinical evaluations
• Participate in training PCS stakeholders as needed
• Perform sedentary work involving extended sitting, close visual acuity, repetitive hand motions, walking, crouching, and lifting up to 10 pounds

Requirements:

• Bachelor’s degree in Nursing or other healthcare field required
• Two years of experience in a home care setting
• Active North Carolina Registered Nurse (RN) licensure required
• Experience with community-based individuals needing personal assistance with ADL and IADL tasks highly preferred
• Experience conducting PCS assessments highly preferred
• Knowledge of North Carolina Medicaid Clinical Coverage Policy 3L and PCS Program Provider Manual
• Knowledge of standards of practice related to Medicaid-funded State Plan Personal Care Services, HCBS programs, and EPSDT
• Knowledge and understanding of public sector services and supports
• Computer proficiency in Microsoft Excel, Word, and Outlook
• Ability to use computer equipment and web-based software
• Ability to interact with office staff, healthcare professionals, patients, families, and other supports
• Effective spoken, written, and electronic communication skills
• Ability to attend to detail, prioritize, and execute tasks in a timely manner
• Ability to work independently without a high degree of supervision
• Ability to use person-centered thinking and planning, with competency in awareness of the needs of persons with disabilities
• Must reside in North Carolina or within 40 miles of the North Carolina border
• Ability to travel as needed to Rowan, Forsyth, Iredell, Yadkin, Davie, and Davidson counties

Benefits:

• Exempt position; not eligible for overtime compensation
• Equal opportunity employer